A recent study in Europe tested the notion of a positive attitude having an influence on medication taken for pain. The study was conducted by Ulrike Bingel, MD, a neurologist at the University Medical Center Hamburg-Eppendorf in Germany. Volunteers who were given a painkiller and were assured that it would work did, in fact, get considerable relief from a brief but intense burning sensation inflicted by the researchers. When the same volunteers were told that they’d have to face the burning without a painkiller, their pain got worse—even though they continued to receive the same dose of the same drug. The study findings suggest that encouraging positive thinking in pain patients may be the key to effective treatments, says Carla Rubingh, a pain management specialist and assistant professor of pharmacy practice at the University of Nebraska Medical Center in Omaha.

“This tells me that when we’re talking to patients and presenting therapy, the more positive we are about how the therapy is going to impact them, the better outcomes we’re going to have,” says Rubingh, who was not involved in the study. “And from the patients’ point of view, this says the more positive and open-minded they are to different types of treatment, the better they’re going to do.”

The information doctors provide about a treatment has a “very powerful” effect on patient expectations, as do a patient’s previous experiences in similar situations, says the lead author of the study, Ulrike Bingel, MD, a neurologist at the University Medical Center Hamburg-Eppendorf in Germany.

But health-care providers aren’t the only ones who influence expectations. “In real life, patients’ expectations are also shaped by the media, the Internet, and [reports] from other patients suffering from the same disease,” Dr. Bingel says. “Intriguingly, even money plays a role. People expect expensive drugs to be more efficacious than cheap drugs, even if the pharmacological content is exactly the same.”

The participants underwent functional magnetic resonance imaging (fMRI) brain scans throughout the experiment. The scans showed that the volunteers had more activity in areas of the brain involved in memory and anxiety when they were expecting pain versus when they were expecting relief. Moreover, when the volunteers were told the drug would work, there was a boost in brain activity in areas associated with fighting pain.

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